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Feddermann: Fewer serious head injuries

The sight of Petr Cech clad in his trademark protective headgear as he kept goal for Chelsea away to Basel in the UEFA Europa League semi-final first leg last Thursday is a poignant reminder of the potentially grave consequences associated with head injuries in football.

The 80g helmet remains a necessity years after Cech suffered a fractured skull in a collision with Stephen Hunt on 14 October 2006. The damaged bones will eventually fuse back together again, but the process takes years and the 30-year-old will wear the helmet until the end of his career.

FIFA has always assigned high priority to the topic of prevention and treatment of head injuries in the men's and women's game. On 1 and 2 November 2012, leading international experts from the IOC, FIFA and other international sports governing bodies met at Home of FIFA in Zurich for the 4th International Consensus Conference on Concussion in Sport.

Recognise symptoms, treat appropriatelyAt the FIFA-organised conference, delegates from the IOC, NFL, NHL, IRB, IIHF, FEI and the Australian Football League pooled their experience and latest thinking on prevention, diagnosis and treatment methods. What are the best procedures for the treatment and prevention of concussion injuries? What is best practice in the touchline assessment of concussion?

Dr Nina Feddermann from Zurich University Hospital’s Neurology Division is a member of FIFA's F-MARC research centre and an expert in this area. Interviewed by dfb.de, the German FA (DFB) website, she provided information and insight into this important topic. “The most frequent head injury in football is soft tissue contusion, followed by laceration. In professional sport, concussion comprises some 13 per cent of all head and neck injuries," she told the website.

“Concussion is characterised by diffuse and generally reversible brain damage, which may rapidly lead to the onset of neurological (e.g. dizziness and headache) and neurocognitive (e.g. memory loss) changes, with or without loss of consciousness immediately after the injury event. There is a debate about a dangerous complication of concussion, so-called ‘second impact syndrome’, a rare phenomenon which can affect players who suffer a second cranial cerebral injury (CCI) in the aftermath of concussion, before they have fully recovered from the first injury event.

"This may in turn lead to a worsening of existing symptoms on the one hand, and on the other to acute, chronic and life-threatening cerebral swelling. For this reason, it's certainly advisable to consult a physician before resuming sporting activity."

Head injuries halved following rule changesConcussion represents a serious threat to health, so it is all the more important to correctly diagnose symptoms such as headache, vomiting, dizziness or memory loss with or without loss of consciousness, to ensure players receive appropriate treatment.

Players who have sustained a head injury should immediately leave the field of play and report for diagnosis to a doctor or qualified medical staff. If the head injury led to a fall, the injured player should initially remain on the field in a comfortable lying position, due to the possibility of spinal injury," continued Dr Feddermann.

Happily, the Zurich-based expert reported a significant reduction in serious head injuries in football. “Since a change in the laws of the game, prescribing a red card for deliberate elbowing, the number of (serious) head injuries has fallen," she said.

“At the 2006 FIFA World Cup, on the basis of the results of a study by FIFA research centre F-MARC, FIFA established that more than half of all head injuries in football (60%) were caused by aerial challenges, especially elbow-to-head or head-to-head contact. This led to a change in the laws, punishing deliberate elbowing to the head with a sending off. Since then, serious head injuries at FIFA tournaments have halved. We now see an average of one concussion event per FIFA tournament."